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Journal of Head Trauma Rehabilitation:
doi: 10.1097/HTR.0b013e3181f8d52d
Original Articles

Using Startle to Objectively Measure Anger and Other Emotional Responses After Traumatic Brain Injury: A Pilot Study

Neumann, Dawn Radice PhD; Hammond, Flora MD; Norton, James PhD; Blumenthal, Terry PhD

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Objective: To determine the effectiveness of a modulated acoustic startle reflex paradigm with emotional imagery in studying physiological changes associated with emotional responses in persons with traumatic brain injury (TBI).

Setting: Outpatient rehabilitation hospital.

Participants: Six individuals with moderate to severe TBI. Mean age was 32 years and mean years postinjury were 9.9.

Method: The modulated acoustic startle reflex procedure involved imagery of emotional scripts (joy, anger, fear, and neutral) followed by a startle noise, versus startle noise alone (no script).

Measures: Eyeblink and skin conductance response, subjective arousal and valence ratings of the scripts, and general anger questionnaire.

Results: Startle blink responses following anger imagery were significantly smaller than those following fear (P = .006) and neutral (P = .023) imagery. Skin conductance response did not change significantly based on the content of the scripts (P = .070).

Conclusions: Large startle blink responses indicate avoidance of a stimulus. Our findings suggest that participants with TBI did not have an avoidant reaction to anger-inducing stimuli. Skin conductance response findings may imply arousal impairments. The modulated acoustic startle reflex was effective in measuring emotional responses; however, larger studies comparing persons with TBI with control groups are needed to further explore these findings.

© 2011 Lippincott Williams & Wilkins, Inc.


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